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Total pelvic exenteration and a new model of diversion for giant primitive neuroectodermal tumor of prostate: A case report and review of the literature |
Lichen Tenga,Liangjun Weia,Li Lib,Yongpeng Xua,Yongsheng Chena,Yan Caoa,Wentao Wanga,Changfu Lia,*()
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a Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China b Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China |
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Abstract The present study reports a rare primitive neuroectodermal tumor (PNET) of prostate. A 27-year-old male was admitted to Harbin Medical University Cancer Hospital (Harbin, China) for dysuria and dyschezia. Magnetic resonance imaging (MRI) revealed a large mass that may involve the bladder and rectum next to the prostate. Histopathological analysis of biopsy of prostate indicated mesenchymal origin tumor, and immunohistochemistric staining confirmed diagnosis of PNET of prostate. En bloc total pelvic exenteration and double barrel sigmoidostomy were performed. Double stomas in the skin incision were used for fecal and urinary diversion, respectively. Short-term outcome is satisfactory, while long-term efficacy remains to be poor. Clinical features of PNET of prostate should be paid much more attention and radical surgery and adjuvant chemotherapy should be recommended.
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Received: 19 November 2017
Available online: 05 April 2019
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Corresponding Authors:
Changfu Li
E-mail: lichangfu2015@sina.com
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Magnetic resonance image (MRI) of the pelvic region. (A) Coronal T2-weighted scan revealing adherence between mass and base of bladder; (B) Sagital T2-weighted image showing a 84 mm × 78 mm × 72 mm mass replaced prostate gland, which compressed posteriorly rectum and superiorly bladder, respectively; (C) Transverse image showing the mass potentially adhere to pelvic wall.
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Double barrel sigmoidostomy: Upper stoma is used for fecal diversion, and lower one is used for urinary diversion.
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Reprehensive images with H&E staining and immunohistochemistric staining. (A) H&E staining revealed a lot of small round cells distributed in tumor region (×200); (B) Immunohistochemistric staining demonstrating small round cells positive for CD99 (×200); (C) and (D) reveal small round cells is positive for CD56 and Vim, respectively (×200); (E) and (F) show small round cells negative for CK (×200) and CD34 (×100), respectively.
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Authors | Age (year) | Surgery | Chemotherapy | Radiotherapy | Metastases | Survival (month) | Peyromaure et al. [2] | 27 | Yes | Yes | No | None | 2 | Collecchia et al. [3] | 31 | Yes | Yes | No | None | N/A | Thete et al. [4] | 26 | N/A | N/A | N/A | None | N/A | Al Haddabi et al. [5] | 24 | No | Yes | No | None | N/A | Kumar et al. [6] | 25 | N/A | Yes | N/A | None | N/A | Zhao et al. [7] | 20 | No | Yes | No | Lung and lymph node | N/A | Liu and Pu [8] | 52 and 47 | Yes | No | No | N/A | N/A | Funahashi et al. [9] | 20 | Yes | Yes | No | Lung | 10 | Mohsin et al. [10] | 29 | No | Yes | No | Lymph node and lung | N/A | Wu et al. [11] | 28 | Yes | Yes | No | N/A | 12+ | Liu and Bu [12] | 27 | Yes | Yes | No | Lung and lymph node | 4 | Liao et al. [13] | 49 | No | Yes | Yes | None | 24+ | Shibuya et al. [15] | 23 | No | Yes | No | Lymph node | 4 | Kord et al. [16] | 38 | Yes | Yes | No | Lung, liver, bone and peritoneum | 14 | Current case | 27 | Yes | No | No | Lung and peritoneum | 5 |
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Clinical characteristics of reported primitive neuroectodermal tumor of prostate cases.
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